Comparison of Health Awareness in South Korean Middle School Students According to Type of Online Physical Education Classes during the COVID-19 Pandemic.

Coronavirus disease 2019 popularized online classes to prevent educational deficits affected by the pandemic. This study aimed to assess the differences in the importance and performance of health awareness in Korean middle school students according to the types of online physical education classes they attended during the coronavirus disease 2019 pandemic. Overall, 583 participants were selected using a convenience sampling method; the data were obtained through an online survey using Google forms. Frequency analysis, reliability analysis, independent sample t-test, and importance-performance analysis were performed. First, the differences between importance and performance were found to be the most for sleep and physical activity management, and the least for disease and hygiene management. In addition, both groups demonstrated higher importance and performance for hygiene and disease management. There were significant differences in the importance and performance of all the sub-factors. Second, hygiene, disease management, and mental health management were found in quadrant I in both groups, while physical activity, sleep, and dietary habit management were in quadrant III. No factors were in quadrants II and IV. Correspondingly, there was no significant difference in adolescents' health awareness between the assignment-based online group and interactive online group.

The Effect of Polarized Training on the Athletic Performance of Male and Female Cross-Country Skiers during the General Preparation Period.

This study aimed to analyze the effect of 12 weeks of polarized training on body composition, cardiorespiratory function, and upper-body power of male and female cross-country skiers during the general preparation period. A total of 16 national cross-country skiers (8 male and 8 female; 8 national cross-country skiers and 8 national biathlon athletes) participated. Polarization training was conducted for 12 weeks from May to July in 2019 during the general preparation period for cross-country skiers. The low-weight, high-repetition method was used for strength training. The effect of the polarized training on body composition, maximum oxygen intake (VO2max), respiratory exchange rate, all-out time, and ski ergometer exercise time was assessed. There was no change in weight, BMI, and muscle mass in male and female cross-country skiers following the 12 weeks of polarized training (p > 0.05). Male body fat percentage (pre 18.1%, post 12.7%) and female body fat percentage (pre 29.1%, post 21.4%) showed a significant decrease (p < 0.05). After training, VO2max increased by 7.72% in male athletes (pre 71.05 mL/kg/min, post 77.0 mL/kg/min) and 6.32% in female athletes (pre 60.26 mL/kg/min, post 64.33 mL/kg/min). Treadmill exercise time increased by 5.39% for male athletes (pre 1038 s, post 1064 s) and 2.23% for female athletes (pre 855 s, post 874 s). However, there was no significant difference between male and female athletes (p > 0.05). The 50% recovery time from the maximum heart rate to the target heart rate decreased by 64.52% in males (pre 168.8 s, post 102.6 s) and 6.48% in females (pre 135 s, post 129.6 s). Significant differences were found only in male athletes (p < 0.05). The double-pole 500 m exercise duration for the ski ergometer significantly decreased after the training for both sexes (p < 0.05). In this study, the 12 weeks of polarized training improved the body composition and athletic performance of all cross-country skiers. Interestingly, in this study, we confirmed that polarized training had a better effect on cardiorespiratory function in male cross-country skiers than in female cross-country skiers. Conversely, we found that the outcomes of the ski ergometer exercise factors were more effective in female athletes than in male athletes. Therefore, we insist that when applying a polarized training program to athletes, it should be planned in detail by sex, exercise amount, intensity, and type of training.

Role of physical exercise in modulating the insulin-like growth factor system for improving breast cancer outcomes: A meta-analysis.

BACKGROUND: Physical activity prevents cancer and improves cancer outcomes. Insulin-like growth factor (IGF) signaling plays a significant role in cancer development and progression. However, there are heterogeneous results regarding physical activity and its effect on the IGF system. This study meta-analyzed the results of randomized clinical trials which evaluated the effects of physical exercise on the changes of physiologic markers to identify the role of physical exercise in modulating the IGF system in women with breast cancer. METHODS: PubMed, Embase, CENTRAL, and SPORTDiscus were systematically searched until October 2020. Eligibility criteria included randomized controlled trials that evaluated the effects of physical exercise on the insulin-like growth factor system among women with breast cancer. RESULTS: Twelve randomized controlled studies involving 736 participants were analyzed. Physical exercise significantly reduced levels of serum insulin (MD -1.24 µIU/mL, 95% CI -2.12 to -0.36, p = 0.006), IGF-II (MD -54.21 ng/mL, 95% CI -61.41 to -47.00, p < 0.00001), IGFBP-1 (MD -2.90 ng/mL, 95% CI -3.91 to -1.90, p < 0.00001), and HOMA score (MD -0.47, 95% CI -0.87 to -0.06, p = 0.02). In addition, serum glucose (MD -0.71 mg/dL, 95% CI -2.57 to 1.15; p = 0.45) and IGF-I levels (MD -5.23 ng/mL, 95% CI -13.00 to 2.53; p = 0.19) were decreased after physical exercise although they did not show a statistical significance. CONCLUSION: Physical exercise had a positive effect on the IGF system in women with breast cancer.

Transcranial Direct Current Stimulation of motor cortex enhances running performance.

Transcranial direct current stimulation (tDCS) is a technique used to modulate neuronal excitability through non-invasive brain stimulation that can enhance exercise performance. We hypothesize that tDCS would improve submaximal running time to exhaustion (TTE) and delay the increase in the rating of perceived exertion (RPE) over time. We also hypothesize that tDCS would not lead to difference in cardiorespiratory responses. We employed a randomized, single-blinded, and counterbalanced design in which 10 trained men participated. After receiving either 20 min of 1.98 mA anodal tDCS applied over the primary motor cortex (M1) or sham-operated control on separate days, participants completed a constant-load test involving running at a speed equivalent to 80% of their own maximum oxygen consumption (VO2max). During this constant-load test, RPE, heart rate (HR), VO2, pulmonary ventilation (VE), respiratory exchange ratio (RER), and ventilatory threshold (VT) were continuously monitored. TTE was recorded at the end of the test. TTEs were significantly longer in the tDCS than in the sham conditions (21.18 ± 7.13 min; 18.44 ± 6.32 min; p = 0.011). For TTE, no significant differences were found in RPE between conditions at isotime. In addition, no significant differences in HR, VO2, VE, RER, and VT were found during TTE between the two stimulation conditions at any time point. These results indicate that the application of tDCS does not induce a change of the exercise performance-related index; however, it can affect the increase of the exercise duration due to the stimuli in the M1 area.

Comparison of Modified Transtibial and Anteromedial Portal Techniques in Anatomic Single-Bundle ACL Reconstruction.

The purpose of this study was to compare the clinical, 3-dimensional computed tomography, magnetic resonance imaging, and second-look arthroscopic findings of the modified transtibial technique with those of the anteromedial portal technique in single-bundle anterior cruciate ligament reconstruction (SB-ACLR). Among patients who underwent SB-ACLR from February 2012 to May 2014, 95 patients with a minimum of 36 months of follow-up were included in this retrospective study. Forty-five patients underwent a reconstruction using the modified transtibial technique. Fifty patients underwent a reconstruction using the anteromedial portal technique. Clinical scores and stabilities were recorded preoperatively and at final follow-up. All patients had postoperative computed tomography and the computed tomography parameters, including tunnel position and graft obliquity, evaluated. Additionally, postoperative magnetic resonance imaging and second-look arthroscopy were performed. On the basis of the functional and stability outcomes, all of the patients showed significant improvement after SB-ACLR, with no significant differences existing between the 2 groups (P>.05). Tunnel position and obliquity were not significantly different between the 2 groups (P>.05). There were no statistically significant differences between the 2 groups regarding the magnetic resonance imaging and second-look arthroscopy findings (P>.05). The tunnel characteristics and clinical results of the 2 techniques were comparable. Given the several advantages of the modified transtibial technique, including its simplicity and patients' greater activity level, it is suitable for anatomic SB-ACLR. [Orthopedics. 2019; 42(2):83-89.].

Training effects of Interactive Metronome® on golf performance and brain activity in professional woman golf players.

During putting in golf, the direction and velocity of the club head should be consistent across swings. In order to maintain consistency in swing timing, the cerebellum provides temporal information, motor timing, control of rhythm, and timing of movements. We utilized Interactive Metronome (IM), a brain training software program that combines the concepts of neurotechnology with the abilities of a computer, to improve an individual's rhythm and timing. We propose that IM would activate neural networks involved in decreasing variation in putt swing. Twenty professional female golfers (KLPGA) were randomly assigned to either an IM training group (n = 10, 35-40 min per session, twice a week for 6 weeks) or a control group (n = 10). The golf putting movements and brain activity were analyzed using Kinovea Software and resting state functional MRI, respectively. Consistency was measured as the standard deviation of mean swing speed (SSD) during three sections of the swing: backswing (AD-BS), backswing-impact (BS-IMP), and impact-finish (IMP-FIS). Our results show that the consistency of the IM group improved in the time between the back swing and impact in the 2 m putt and 5 m putt compared to the control group. Using functional MRI, after the training period, the IM group showed increased functional connectivity from the superior cerebellar vermis to the right medial frontal gyrus, left superior temporal gyrus, right middle occipital gyrus, right middle temporal gyrus, right cingulate gyrus, and right supramarginal gyrus (uncorrected p < 0.001, voxels > 40). These findings suggest that IM training in professional female golf players may improve consistency in putt timing. In addition, IM training may increase brain connectivity from the cerebellum to the frontal cortex, which plays an important role in motor control and timing.

A case of bilateral revision total knee arthroplasty using distal femoral allograft-prosthesis composite and femoral head allografting at the tibial site with a varus-valgus constrained prosthesis: ten-year follow up.

BACKGROUND: We report the successful use of allograft-prosthesis composite (APC) and structural femoral head allografting in the bilateral reconstruction of large femoral and tibial uncontained defects during revision total knee arthroplasty (RTKA). CASE PRESENTATION: A 67-year-old female with degenerative arthritis underwent bilateral total knee arthroplasty (TKA) using the Press Fit Condylar (PFC) modular knee system at our clinic in March, 1996. At 8 years postoperatively, the patient presented with painful, bilateral varus knees, with swelling, limited passive range of motion (ROM), and severe instability. We treated to reconstruct both knee using a femoral head allograft at the tibial site, a structural distal femoral allograft at the femoral site, and a varus-valgus constrained (VVC) prosthesis with cement. At the 10-year follow up, we found no infection, graft failure, loosening of implants, in spite of using massive bilateral structural femoral head allografts in RTKA. CONCLUSION: The use of APC enabled a stable and durable reconstruction in this uncommon presentation with large femoral bone deficiencies encountered during a RTKA.

Clinical and radiological results of cruciate-retaining total knee arthroplasty with the NexGen®-CR system: comparison of patellar resurfacing versus retention with more than 14 years of follow-up.

BACKGROUND: The purpose of this study is to analyze clinical and radiological outcomes of patients (with a minimum of 14 years of follow-up) who underwent cruciate-retaining (CR) total knee arthroplasty (TKA) using a NexGen®-CR, comparing a patellar resurfacing group with a patellar retention group. METHODS: From June 1996 to April 2002, 116 cases of TKA using a NexGen®-CR who had at least 14 years of follow-up were enrolled in this study. Among them, 68 cases had patellar resurfacing and 48 had patellar retention. The average follow-up period was 14.8 years (14.1-18.7). Clinical scores and range of motion (ROM) were evaluated preoperatively and at the last follow-up in all patients. The Hospital for Special Surgery (HSS) score, Knee Society Score (KSS), Western Ontario and MacMaster Universities Osteoarthritis (WOMAC) score, and a new patellar score were assessed. Radiological evaluations are done by analyzing the tibiofemoral angle, loosening, and a radiolucent line on the radiograph by American Knee Society Roentgen Graphic Evaluation. RESULTS: The average HSS score of both the patellar resurfacing group and retention group increased from 42.3 and 41.2 preoperatively to 90.2 and 90.8 at the last follow-up, respectively. The KSS, WOMAC score, patellar score, and knee joint ROM also improved significantly in both groups. However, there were no significant differences in clinical results between the two groups. On the radiological evaluation, the tibiofemoral angle in both groups had improved from varus 7.8° and 7.2° preoperative to valgus 4.9° and 4.8°, respectively. The average angles of α, ß, γ, and δ were 94.1°, 90.4°, 3.2°, and 87.8° in the patellar resurfacing group and 94.4°, 89.8°, 3.3°, and 88.1° in the patellar retention group, respectively. A radiolucent line shown on radiograph was noted in a total of seven cases, three in the patellar resurfacing group and four in the patellar retention group. In the patellar resurfacing group, among the seven zones on the tibia radiograph, all cases were located at the medial side of tibia and two cases were in zone 1 and one case in zone 2, and in the patellar retention group, three cases were in zone 1 and 1 case was in zone 2, also located on the same side. CONCLUSIONS: We achieved satisfactory clinical and radiological outcomes on long-term follow-up when performing TKAs with a NexGen®-CR. There was no significant difference in clinical or radiological results between the patellar resurfacing and retention groups in our study.

Brain networks governing the golf swing in professional golfers.

Golf, as with most complex motor skills, requires multiple different brain functions, including attention, motor planning, coordination, calculation of timing, and emotional control. In this study we assessed the correlation between swing components and brain connectivity from the cerebellum to the cerebrum. Ten female golf players and 10 age-matched female controls were recruited. In order to determine swing consistency among participants, the standard deviation (SD) of the mean swing speed time and the SD of the mean swing angle were assessed over 30 swings. Functional brain connectivity was assessed by resting state functional MRI. Pro-golfers showed greater positive left cerebellum connectivity to the occipital lobe, temporal lobe, parietal lobe and both frontal lobes compared to controls. The SD of play scores was positively correlated with the SD of the impact angle. Constant swing speed and back swing angle in professional golfers were associated with functional connectivity (FC) between the cerebellum and parietal and frontal lobes. In addition, the constant impact angle in professional golfers was associated with improved golf scores and additional FC of the thalamus.

Risedronate directly inhibits osteoclast differentiation and inflammatory bone loss.

Risedronate, a nitrogen-containing bisphosphonate, is widely used in the clinical field for the treatment of osteoporosis. Risedronate is known to exert its effects through binding to hydroxyapatite in bone tissue, inhibiting osteoclastic activity, and inducing apoptosis of osteoclasts. The purpose of this study was to determine the effects of risedronate on osteoclast differentiation in vitro and on an inflammatory bone loss model in vivo. Risedronate inhibited osteoclast differentiation in co-culture of bone marrow cells (BMCs) and osteoblasts, and suppressed receptor activator of nuclear factor (NF)-kappaB ligand (RANKL)-mediated osteoclast differentiation from bone marrow-derived macrophages (BMMs) in a dose-dependent manner without toxicity. Risedronate significantly inhibited expression of c-Fos and nuclear factor of activated T cells (NFAT) c1 induced by RANKL. To examine the effect of risedronate on bone loss in vivo, we used a mouse model of lipopolysaccharide (LPS)-mediated bone loss. Micro-CT analysis of the femurs showed that LPS treatment caused bone loss. However, bone loss was significantly attenuated in mice administered with risedronate. Taken together, we conclude that risedronate exerts beneficial effects on osteoporosis by inhibiting osteoclast differentiation both directly and indirectly. In infectious conditions, the inhibitory effect of risedronate on bone erosion was excellent. Thus risedronate could be a treatment option for osteoporosis caused by inflammatory and infectious conditions.

Ammonium glycyrrhizinate protects gastric epithelial cells from hydrogen peroxide-induced cell death.

Glycyrrhiza uralensis has a potential for preventing or ameliorating gastric mucosal ulceration. To understand the molecular mechanism about the medicinal effect of G. uralensis, we isolated four single compounds from G. uralensis and one related compound and screened for the cellular protective effect against H(2)O(2)-induced damage in gastric epithelial AGS cells. Interestingly, we found that ammonium glycyrrhizinate (AG) prepared from glycyrrhizin dramatically protects AGS cells from H(2)O(2)-induced damage as measured by the integrity of actin cytoskeleton. AG also inhibited FeSO(4)-induced reactive oxygen radicals in a dose-dependent manner, suggesting the role for AG as a free radical scavenger. To better understand the protective role of AG at the transcriptional level, we performed genome-wide expression profiling using high-density oligonucleotide microarrays, followed by validation using RT-PCR. Among the 33,096 genes that were screened in the microarray, 936 genes were found to be differentially expressed in a statistically significant manner in the presence or absence of H(2)O(2) and AG. Among the 936 genes, 51 genes were differentially expressed at least 3-fold in response to the H(2)O(2) treatment. AG blocked the expression of genes related to apoptotic cell death (GDF15, ATF3, TNFRSF10A, NALP1) or oxidative stress path-ways (HMOX1) which was elevated in response to H(2)O(2) treatment, suggesting a potential protective role for AG in oxidative stress-induced cell death. Collectively, current results demonstrate that AG is a novel antioxidant that could be effective for the treatment of gastric diseases related to the oxidative stress-induced mucosal damage.

Active Video Games and Energy Expenditure in Overweight Children.

The prevalence of overweight in children has increased significantly in recent years. Frequent television viewing and the playing of video games have often been linked to the high prevalence of overweight. The purpose of this study was to determine if overweight children, given access to active video games, will play them at an intensity that will significantly increase energy expenditure. Twenty-three children, classified as "at risk for overweight" or "overweight," participated in this study. After a 10-minute baseline period in which the children watched a cartoon, the participants played the Jackie Chan Fitness Studio® (Xavix, Hong Kong) games for 30 minutes while rotating through the games as desired and resting whenever needed. Energy expenditure significantly increased from a mean at baseline of 1.15 ± 0.32 kcal/min to 4.08±1.18 kcal/min during the 30-minutes that the participants were given access to the games (p <.001). The total energy expenditure during the 30-minute time frame was 122.30 ± 35.40 kcal. The energy expenditure varied between individuals, with a low value of 75.00 kcal to a high of 205.86 kcal. Although a modest level of energy expenditure, this level of exertion could contribute to an overall weight control program in children.